Is interferon-α and retinoic acid combination along with radiation superior to chemo-radiation in the treatment of advanced carcinoma of cervix?

Abstract

Locally advanced cervical cancers comprise a large majority of the gynecologic cancers in India and other developing countries. Concurrent chemo-radiation has improved the survival of high risk stage I and stage II cervical cancers. There is no evidence that the same survival benefit has been achieved with chemo-radiation in stage III and stage IV disease. Interferon-a and Retinoic acid have synergistic anti-proliferative activity. In combination with radiation, they substantially enhance the sensitivity of the squamous carcinoma cells to radiation. Based on these observations from the in vitro studies, a few clinical trials have evaluated the combination of interferon-a and Retinoic acid, concomitant with radiation, to treat cervical cancers. The results from these early trials were encouraging and the combination had minimal toxicities. However, till date, no phase III randomized controlled trial has been done to evaluate this therapeutic modality.

Type I interferons as radiosensitisers for pancreatic cancer

“…[6][7][8][9][10] In several tumours radiosensitising properties of interferon alpha (IFNa) and interferon beta (IFNb) have been demonstrated in vitro [13][14][15][16][17] as well as in vivo. 18,19 In pancreatic cancer cell lines, IFNa has already shown to act as radiosensitiser 20 and in vivo promising therapy results have been reported combining 5-FU, cisplatinum, and radiation therapy with IFNa alone (5-year survival rate of 55%) or followed by 2 cycles of gemcitabine (median survival 25 months) in patients with resected pancreatic adenocarcinoma. 21,22 These results are currently reinvestigated in the phase III CapRI study.…”

Evolution of patterns of care for women with cervical cancer in Morocco over a decade

“…The National Cancer Institute (NCI) of the USA made a clinical announcement in 1999 recommending the use of chemoradiation for all cervical cancer patients undergoing RT [ 22 ]. This announcement was based on the outcomes of three randomized trials published almost simultaneously demonstrating nearly 50% improvement in survival with chemoradiation [ 23 – 26 ]. In Morocco approximately half of the patients receiving RT did not receive concomitant CT. Concurrent chemotherapy with radiation being a routine practice at both CM-VI and INO to treat cervical cancer during entire study period, the oncologists at both the centers felt that the proportion of patients reported to have missed chemotherapy was too high.…”

Evaluation of serum adenosine deaminase and gamma glutamyl transferase in cancer cervix -A low-cost diagnostic tool

“…Due to lack of awareness, cervical cancer screening is not done in early stages, 70-80% of the patients are diagnosed at advanced stages (stage III and stage IV) with poor long-term survival. 21 Being the leading cause of cancer associated death in women of our country, successful cervical cancer screening programs have been difficult to implement at low source setting because of many factors. Foremost is the expense of maintaining the infrastructure and technical expertise required for cytological screening.…”